The present invention relates instruments and methods for inserting and manipulating surgical instruments.
Various instruments and methods have been developed for surgical procedures that employ an anterior approach to an operative site in a patient through one or more access sleeves, through an open surgical procedure, or through one or more micro-incisions. Endoscopic visualization along with other known visualization instruments and insufflation techniques can be used during such procedures to aid in surgeon visualization and access of the operative site. Such procedures can be used to access the spinal column to perform surgical procedures including discectomies; disc space distraction and preparation; artificial disc, interbody spacer, or fusion implant insertion; and/or installation of plates, rods, cables, tethers along with the associated hardware for engaging the vertebral bodies. Locations other than the spinal column can also be accessed through an anterior approach to perform surgical procedures at an operative site in a patient.
One problem associated with anterior approaches to a surgical site is that the vasculature anatomy and other anatomic structures limit the working space available to the surgeon. Another problem is that operative instruments and elements inserted to the operative site occupy working space that could be better utilized by the surgeon if available to him or her. This limitation in the available working space makes some procedures difficult, impracticable, and/or unsafe for the surgeon to conduct. There remains a need for instruments and methods that can be employed in anterior approaches that provide the surgeon greater access to the operative site. The present invention is directed to meeting these needs, among others.
The present invention provides a surgical instrument assembly and method for an anterior surgical approach that provide the surgeon greater access to the operative site in a patient""s body. In one form, the surgical instrument assembly includes an operative element coupled to an insertion instrument for inserting the operative element. A transfer instrument is then coupled to the inserted operative element. The insertion instrument is then removed and the transfer instrument maintains the operative element at the surgical site and can also be used to manipulate and reposition the operative element.
The surgical instrument assembly of the present invention can be inserted through access sleeves into the patient in an insufflated or non-insufflated environment, through micro-incisions, or through open surgical procedures in which the skin and tissue is retracted to expose the operative site.
In one specific application, the insertion instrument and operative element are inserted through a first port sized to receive the operative element. The transfer instrument is inserted through a second smaller port through which the operative is too large for insertion. The transfer instrument is coupled to the operative element, and the insertion instrument is removed from the first port. The first port is available to receive other surgical instruments for performing other procedures at the operative site.
In a further form, a vein retractor operative element is provided along with surgical techniques employing the same with the surgical instrument assembly of the present invention.
Other aspects, forms, embodiments, objects, features and advantages of the present invention will be apparent from the following description of the illustrated embodiment.